Emergency Extension - National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities

ICR 202010-0920-008

OMB: 0920-1306

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Justification for No Material/Nonsubstantive Change
2020-10-15
Supporting Statement B
2020-10-15
Supporting Statement A
2020-10-15
Supplementary Document
2020-10-15
IC Document Collections
ICR Details
0920-1306 202010-0920-008
Historical Active
HHS/CDC 0920-21
Emergency Extension - National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities
New collection (Request for a new OMB Control Number)   No
Emergency 10/15/2020
Approved with change 10/15/2020
Retrieve Notice of Action (NOA) 10/15/2020
CDC will commit to evaluating responses and updating associated burdens when this emergency is transitioned into the larger NHSN COVID package.
  Inventory as of this Action Requested Previously Approved
11/30/2020 1 Months From Approved
1,098,200 0 0
137,275 0 0
0 0 0

The goal of this information collection is to 1) capture the daily, aggregate impact of COVID-19 on healthcare facilities, and 2) monitor medical capacity to respond at local, state, and national levels. This information will be used to inform the overall real-time COVID-19 response efforts and possible resource allocation, and enable state and local health departments to gain immediate access to the COVID-19 data for hospitals within their jurisdiction.
CDC seeks a one-month extension of the expired 0920-1290 - National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities package, so that it can incorporate a new data collection form to the NHSN COVID-19 Long Term Care Facility (LTCF) Module: Point of Care Testing Results form (CDC 57.1) The data collected via this form will inform state and local health departments as well as federal public health entities about testing results for patients and staff in nursing homes. This data will be used to identify COVID-19 outbreaks in nursing homes, add to the situational awareness of COVID-19 in jurisdictions, as well as to enable public health agencies to assist in infection prevention and control activities. NHSN has requested OMB approval of this form by 10/15/2020. In order for this nonmaterial/non-substantive change request to be approved, an emergency request to extend the National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities package (0920-1290), is hereby submitted. The changes made as the result of this nonmaterial/non-substantive change request will be incorporated into the standard package upon approval by OMB.

None
None

Not associated with rulemaking

No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,098,200 0 0 1,098,200 0 0
Annual Time Burden (Hours) 137,275 0 0 137,275 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Addition of Point of Care Form to LTCF Module

No
    Yes
    No
No
No
No
Yes
Jeffrey Zirger 404 639-7118 wtj5@cdc.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/15/2020


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